Provider Demographics
NPI:1073814760
Name:LIN, FELIX (DO)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 VILLAGE LOOP RD STE D
Mailing Address - Street 2:PMB 117
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-4870
Mailing Address - Country:US
Mailing Address - Phone:909-580-1000
Mailing Address - Fax:
Practice Address - Street 1:8 VILLAGE LOOP RD STE D
Practice Address - Street 2:PMB 117
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-4870
Practice Address - Country:US
Practice Address - Phone:909-580-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11453207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine